<%@ page contentType="text/html;charset=UTF-8" %>
<%@ include file="/WEB-INF/views/include/taglib.jsp" %>
<script>
</script>



<div class="content-wrap">
    <section class="panel panel-default">
        <div class="panel-body">
            <div class="col-lg-12" >
                <form:form id="inputForm" data-parsley-validate="" modelAttribute="treatRecordItem" method="post"
                           class="form-horizontal">
                    <form:hidden path="id"/>
                    <%--<form:hidden path="newDept" value="${doctorTempla.billingDept}"/>--%>
                    <form:hidden path="applyId"/>
                    <div class="form-group">
                        <label class="col-sm-2 control-label">主诉：</label>

                        <div class="col-sm-10">
                            <form:textarea path="zhusu" id="zhusu" cssStyle="height: 115px;" data-parsley-required="true" htmlEscape="false" class=" form-control"/>
                        </div>
                        <%--<div class="complaint-input" contenteditable="true" submit_id="zhusuId">--%>
                                <%--${treatRecordItem.zhusu}--%>
                        <%--</div>--%>
                    </div>
                    <div class="form-group">
                        <label class="col-sm-2 control-label">现病史：</label>

                        <div class="col-sm-10">
                            <form:textarea path="xianbingshi" cssStyle="height: 115px;"  id="xianbingshi"  htmlEscape="false" class="form-control"/>
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-sm-2 control-label">个人史：</label>

                        <div class="col-sm-10">
                            <form:textarea path="gerenshi" cssStyle="height: 115px;"   id="gerenshi" htmlEscape="false" class="form-control"/>
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-sm-2 control-label">既往史：</label>

                        <div class="col-sm-10">
                            <form:textarea path="jiwangshi" cssStyle="height: 115px;"  id="jiwangshi" htmlEscape="false" class="form-control"/>
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-sm-2 control-label">婚育史：</label>

                        <div class="col-sm-10">
                            <form:textarea path="hunyushi" cssStyle="height: 115px;"  id="hunyushi" htmlEscape="false" class="form-control"/>
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-sm-2 control-label">家族史：</label>

                        <div class="col-sm-10">
                            <form:textarea path="jiazushi" cssStyle="height: 115px;"  id="jiazushi" htmlEscape="false" class="form-control"/>
                        </div>
                    </div>
                    <%--<div id="examineDivId" style="padding: 0px">--%>
                        <%--<div class="complaint-check">--%>
                            <%--<div>检查检验</div>--%>
                        <%--</div>--%>
                        <%--<div class="animal">T: <form:input path="tiwen" data-parsley-twonum="1" type="text" name="tiwen" value="${treatRecordItem.tiwen}" class="form-input"/> °C</div>--%>
                        <%--<div class="animal">B: <form:input  path="maibo" data-parsley-twonum="1" type="text" name="maibo" value="${treatRecordItem.maibo}"  class="form-input"/> 次/分</div>--%>
                        <%--<div class="animal">R: <form:input path="huxi"  type="text" name="huxi" value="${treatRecordItem.huxi}" class="form-input"/> 次/分</div>--%>
                        <%--<div class="animal"> BP: <form:input path="xueya"  type="text" name="xueya" value="${treatRecordItem.xueya}" class="form-input"/> mmHg</div>--%>
                        <%--<div class="complaint">--%>
                            <%--<div>体格检查</div>--%>
                        <%--</div>--%>
                        <%--<form:input path="tigejiancha" type="hidden"  id="tigejianchaId" value="${treatRecordItem.tigejiancha}" />--%>
                        <%--<div class="complaint-input" contenteditable="true" submit_id="tigejianchaId">--%>
                                <%--${treatRecordItem.tigejiancha}--%>
                        <%--</div>--%>
                        <%--<div class="complaint">--%>
                            <%--<div>专科情况</div>--%>
                        <%--</div>--%>
                        <%--<form:input path="xiaojiefenxi" type="hidden"  id="xiaojiefenxiId" value="${treatRecordItem.xiaojiefenxi}" />--%>
                        <%--<div class="complaint-input" contenteditable="true" submit_id="xiaojiefenxiId">--%>
                                <%--${treatRecordItem.xiaojiefenxi}--%>
                        <%--</div>--%>
                        <%--<div class="complaint">--%>
                            <%--<div>辅助检查</div>--%>
                        <%--</div>--%>
                        <%--<input form:input path="fuzhujiancha"  type="hidden"  id="fuzhujianchaId" value="${treatRecordItem.fuzhujiancha}" />--%>
                        <%--<div class="complaint-input" contenteditable="true" submit_id="fuzhujianchaId">--%>
                                <%--${treatRecordItem.fuzhujiancha}--%>
                        <%--</div>--%>
                    <%--</div>--%>
            <div class="form-group">
                <div class="col-sm-offset-2 col-sm-10">
                    <input id="btnSubmit"
                           onclick="saveSub('treatProjectItem','inputForm','${ctx}/treatProjectItem/treatProjectItem/saveRecord',
                                   '${ctx}/treatrecorditem/treatrecorditem/treatRecordItem/form?applyId=${treatRecordItem.applyId}','${treatRecordItem.applyId}')"
                           class="btn btn-primary" type="button" value="保 存">&nbsp;
                    <%--<input id="btnCancel" class="btn" type="button" value="返 回">--%>
                </div>
            </div>
            </form:form>
        </div>

</div>
</section>
</div>